European Code Against Cancer, 5th edition – tobacco and nicotine containing products, second‐hand smoke, alcohol and cancer

Tobacco use, second-hand tobacco smoke (SHS) exposure and alcohol consumption are well-established carcinogens and major public health concerns. In the European Union (EU), tobacco and alcohol use are the leading preventable causes of cancer and four other major noncommunicable diseases (NCDs), significantly contributing to NCD-related morbidity and mortality. Despite declining prevalence, consumption of these substances is still high in the region, especially among the most deprived. There is strong evidence that quitting smoking, minimising exposure to SHS and eliminating or reducing alcohol intake substantially lowers the risk of cancer. Comprehensive public health strategies at both the individual and population level are crucial to prevent cancer and other NCDs. Scientific evidence leads to two recommendations for individual action on tobacco in the European Code Against Cancer, 5th edition: (1) 'Do not smoke. Do not use any form of tobacco, or vaping products. If you smoke, you should quit'; and (2) 'Keep your home and car free of tobacco smoke'; and one on alcohol: (3) 'Avoid alcoholic drinks'.